Improving the quality, accessibility and range of options to treat harmful substance use including substance use disorders (Treatment)
A Systems Approach to Substance Use in Canada: Recommendations for a National Treatment Strategy is the product of a cross-Canada National Treatment Strategy Working Group established in 2007 to improve the quality, accessibility, and range of options to address harmful substance use - one of 13 priority areas identified under the National Framework for Action to Reduce the Harms Associated with Alcohol and Other Drugs and Substances in Canada. Action on this priority area was initiated and supported by the British Columbia Mental Health and Addiction Services, the Centre for Addiction and Mental Health, and the Canadian Centre on Substance Abuse. The Working Group was composed of representatives from across jurisdictions and sectors, with clinical, policy, government, community, First Nations, Inuit, client, and caregiver experience and expertise and chaired by two representatives of the Canadian Executive Council on Addictions (CECA): Gail Czukar from the Centre for Addiction and Mental Health and Patrick Smith from BC Mental Health and Addiction Services. The group drew on background materials presenting current knowledge and best practice as well as their own areas of expertise in order to develop a comprehensive, evidence-based report.
The National Treatment Strategy Working Group drew on five background papers that were prepared to inform discussion and provide a basis for the final report. On behalf of the Working Group, the Co-Chairs would like to recognize the important contribution made by the authors of these papers:
Responding to the Risks and Harms of Problem Substance Use: Rethinking the Continuum of Care
Deborah Ross, BC Mental Health and Addiction Services
Wayne Skinner, Centre for Addiction and Mental Health
David Brown, BC Mental Health and Addiction Services
Background Paper on Substance Abuse Treatment Indicators and Performance Monitoring in Canada
Gerald Thomas, Centre for Addictions Research BC
Improving Practice in Substance Use Treatment Through Knowledge Exchange: Promoting Synergies Between Research and Practice
Peter Coleridge, BC Mental Health and Addiction Services
Dan Reist, Centre for Addictions Research BC
Eugenia Didenko, Centre for Addictions Research BC
David Brown, BC Mental Health and Addiction Services
Raising Substance Use Treatment on the Policy Agenda
Rebecca Jesseman, Canadian Centre on Substance Abuse
Applying a gender and diversity analysis to the Canadian treatment system: Providing Population Informed Treatment
Gloria Chaim, Centre for Addiction and Mental Health
Nancy Poole, BC Centre for Excellence in Women’s Health
Updates from the National Treatment Strategy Working Group:
- Final Report: A Systems Approach to Substance Use: Recommendations for a National Treatment Strategy
- Executive Summary
- National Treatment Strategy Working Group Members
- Announcement: Pan Canadian Working Group develops a strategy for innovation and coordination in addiction services.
- Backgrounder: A Systems Approach to Substance Use: Recommendations for a National Treatment Strategy
- PowerPoint: A Systems Approach to Substance Use: Recommendations for a National Treatment Strategy
Research has demonstrated that providing a range of options to treat harmful substance use, including substance use disorders, is cost effective in reducing morbidity, mortality and health care utilization. Hence, the allocation of resources sufficient to ensure an appropriate level of care is a pre-requisite. If these services and programs could be better integrated within the health care, mental health, education, social service and criminal justice systems, then a healthier Canada would result.
With integration, many more Canadians would be able to access suitable treatment options, such as brief counselling interventions by health care and social service workers. Moreover, screening and identification rates in health care facilities would improve, trainees and clinicians would be better educated in substance abuse and concurrent disorders, and health care facilities with existing rudimentary treatment programs also would provide better service.
Currently, many Canadians do not have access to the full range of services and programs of the treatment continuum. These include: brief interventions, more intensive outpatient and day treatment, pharmacotherapy as well as short and longer-term residential treatment. Treatment for those with concurrent disorders may currently be inadequate or non-existent, even in large urban centers. Individuals with serious substance use disorders have unequal access to medical treatments and social supports that are essential for long-term recovery; and in-patient, residential treatment and withdrawal management services for youth could be significantly upgraded – right across the country.
It is a widely held belief that Canada needs to increase funding for pharmacological supports for the comprehensive treatment of substance use disorders. For example, naltrexone and disulfiram are under-prescribed and are often not covered under provincial drug plans; not all communities throughout Canada have equal access to methadone treatment; and acamprosate and buprenorphine are not yet widely available in Canada.
Planners, clinicians and researchers in the substance abuse field need to work together to ensure that all Canadians have access to a range of high-quality and effective services and programs along the treatment continuum. Through advocacy, the government and the public need to understand that substance use treatment should be given the priority it deserves. There needs to be increased collaboration with others in the health care, education, social service and criminal justice systems to ensure that effective treatment services/ programs are available to those who use substances in a harmful way and/or to those who have a substance use disorder, when and where they need them.
More information can be found in the Treatment Foundational Activities.